Indozyaningrün-Plasmaverschwinderate

Abstract

Adequate perfusion of the hepato-splanchnic tract, which today can be assessed by the indocyanine green plasma disappearance rate (ICG-PDR), is crucial in critically ill patients. In this study, different variables of liver function and cellular integrity, and systemic oxygen transport were compared. A total of 80 patients (27 female, 53 male, mean age 66±11, range 37-86 years) after elective cardiac surgery were enrolled. Besides lactate, bilirubin, central venous oxygen saturation (ScvO 2 ), serum protein, albumin, activities of cholinesterase, aspartate-aminotransferase, alanine-aminotransferase, gamma glutamyl transpeptidase, alkaline phosphatase, and glutamate dehydrogenase were determined immediately postoperatively. ICG-PDR was measured by a transcutaneous system. In 8 patients, an intra-aortic balloon pump was placed intraoperatively; one patient died during the course on the ICU. Postoperative duration of mechanical ventilation was 28±54 h (median 9 h), length of ICU stay was 4±6 d (median 2 d). Relationship between aortic cross-clamping time and the following parameters was described by r=-0.29 (ICG-PDR), r=0.24 (bilirubin), r=0.41 (lactate), and r=0.12 (ScvO 2 ). No relation was found between ICG-PDR and ScvO 2 (r=-0.16).Thus, ICG-PDR correlates more with aortic cross-clamping time than bilirubin or other tests of liver function or cellular integrity. Regional blood flow and function (ICG-PDR) cannot be estimated by variables of systemic oxygen transport (ScvO 2 ).